Active care processes: diagnosis and treatment

Innovations

As an expansion to an existing community-based oral health program for Hispanic and African-American seniors, dental school faculty, staff, and students offer education and screening for hypertension and diabetes, leading to the identification of many seniors with or at high risk for these chronic illnesses and many previously diagnosed individuals who do not have the condition(s) under control.

An online system provides real-time review and eligibility determination for applicants to Oklahoma's Medicaid and the Children's Health Insurance Program, leading to much quicker enrollment, significant cost savings, and a decline in the number of uninsured.

A multifaceted program featuring education and feedback, ultraviolet room disinfection devices, and a dedicated housekeeping team significantly improved the thoroughness of room cleanings and reduced the percentage of rooms housing patients with Clostridium difficile infections that tested positive for the pathogen at patient discharge.

The combination of a small financial incentive and patient education leads to a modest, short-lived increase in physician visits, but has no effect on blood pressure control or on racial and ethnic disparities in management and control of hypertension.

Emergency department clinicians and staff identify veterans at moderate risk of suicide, work with them to develop a safety plan, and follow up after discharge to ensure adherence to the plan and connections to community-based support, leading to better access to outpatient mental health services.

A children's hospital uses an enterprise data warehouse to assist multidisciplinary teams in identifying and addressing opportunities to improve quality, leading to better adherence to evidence-based guidelines, less unnecessary care, and significant cost savings.

A low-cost, community-based, culturally tailored education program led by a bilingual nurse practitioner helped Korean immigrants with type 2 diabetes improve self-management behaviors and achieve better control of the disease.

The Oregon Health Authority (which oversees the State Medicaid program) initiated a series of policy changes to promote earlier detection, more effective referrals, and better coordination of care for pediatric patients with developmental delays, leading to a significant increase in screening rates and enhanced access to early intervention services.

Psychiatric fellows and residents at the University of Virginia Health System in Charlottesville provide care via videoconferencing to patients in rural parts of the state who otherwise would likely not have had access to such care.